Obamacare Repealed: Now What?

It’s no secret — Congress Republicans are focused on repealing and replacing the Affordable Care Act (“ACA”).  But when will the repeal occur?  What will the ACA be replaced with?  How will the repeal and replacement affect the ACA marketplace?  Will there even be a subsidized marketplace?  These are questions that ring through the minds of people who have a health care plan through the ACA exchange. Unfortunately for people on the exchange (and Congress Republicans), these questions have no simple answer. 

Many people, such as Darlene Hawkes, a 55-year-old North Carolinian resident who holds a health care plan through the ACA marketplace, presume the worst.  Hawkes has had a host of medical issues: heart issues since birth and as a result having open heart-surgery as well as breast-cancer surgery.  With her unfortunate medical problems, Hawkes was unable to afford insurance without the help of a subsidy from the ACA marketplace.  Naturally, Hawkes was struck with the fear of losing her health insurance after hearing the results of the 2016 election.  The sad truth is that Hawkes is only one of over 545,000 North Carolinians who rely on the ACA marketplace.  Making matters worse, more and more people are joining the ACA marketplace. Kevin Counihan, the CEO of Healthcare.gov, cannot predict whether coverage will remain but has stated that “enrollment is higher than expected” for the upcoming year. 

The year of 2017 will inevitably foreshadow what is to come in the future of health care.  In late January, President Trump said that the next two years would see “the busiest Congress we have had in decades, maybe ever.”  And Speaker Paul Ryan said that Congress will be setting forth a “bold, aggressive agenda because we are trying to fix people’s problems in this country.”  Yet this “bold, aggressive agenda” is exactly what many people, like Darlene Hawkins, are concerned about.  The GOP-controlled Congress is able to repeal the current ACA, but a critical question remains - what will the ACA be replaced with?  This seems to be the daunting question that no one is prepared to answer.  Or if an answer has been proposed, it hasn’t been accepted yet. 

With the uncertainty surrounding the future of health care, it should come as no surprise that people are worried about being unable to afford health care being that it can be extremely expensive.  2017 projections show that ACA marketplace premiums​ will increase by as much as 75% in large cities notwithstanding changes from Congress.  As premiums rise it will become more and more possible that many of these people will be unable to afford health care even with a subsidy. 

While efficiently distributing health care seems endlessly complicated on the regulatory level, most people receiving health care on the individual market simply request one thing: quality health care at an affordable price.  Whether good or bad, Congress’s intention to repeal and replace the ACA will surely have implications and only time will tell whether these concerns from people like Darlene Hawkes will be regretfully vindicated. 

Colin Rathe is a current student at DePaul University College of Law. Colin previously attended Illinois Wesleyan University where he received his Bachelor of Arts degree.  He has a wide interest in a variety of litigation-related courses, and has a special interest in health law.  Colin will graduate in May of 2018. 
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